title: Combined effect of smoking and occupational exposure to dusts, gases or fumes on the incidence of COPD.
abstract: To assess risk factors related to the development of chronic obstructive pulmonary disease (COPD) including smoking and occupational exposure (OE) to dusts, gases or fumes, we performed a longitudinal 11-year follow-up postal survey. The original study population was a random population sample of 8000 inhabitants of Helsinki aged 20 to 69 years in 1996. Participants of the first postal questionnaire were invited to this follow-up survey in 2007 with 4302 (78%) answers obtained. Cumulative incidence of COPD in 11 years was 3.43% corresponding to an incidence rate of 3.17/1000/year after exclusion of those with self-reported physician-diagnosed COPD and ever COPD in 1996. Smoking and age, but not gender, were associated with incident COPD. Reported family history of COPD increased the cumulative incidence to 8.55% vs 3.04% among those without a family history (p < 0.001). In multivariate analysis, significant independent risk factors for incident COPD were: current smoking in 1996 (OR 4.40 [95% CI 2.89-6.71]), age over 50 (OR 3.42 [95% CI 2.22-5.26]), family history of COPD (OR 2.08 [1.27-3.43]), ever asthma (OR 2.28 [1.35-3.86]), and self-reported OE (OR 2.14 [1.50-3.05]). Occupational exposure to dusts, gases or fumes, assessed both based on self-reported exposure and a job exposure matrix using reported professions, was an independent risk factor for incident COPD. Smoking and OE together yielded an additive effect on incidence of COPD.
authors.affiliation: 1Team for Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health , Helsinki , Finland.
authors.forename: Paula
authors.initials: P
authors.lastname: Pallasaho
authors.forename: Annette
authors.initials: A
authors.lastname: Kainu
authors.forename: Anssi
authors.initials: A
authors.lastname: Sovijärvi
authors.forename: Ari
authors.initials: A
authors.lastname: Lindqvist
authors.forename: Päivi L
authors.initials: PL
authors.lastname: Piirilä
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001249:Asthma / Q000453:epidemiology; D015331:Cohort Studies; D004391:Dust; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005740:Gases; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D016017:Odds Ratio; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D004391:Dust; D005740:Gases